QUESTION:

Dear Dr. Heller,

Not sure how to word this. Will Paxil do the job it is suppose to for the depressed person who continues to smoke marijuana? To me it would put that person on an emotional roller coaster, and in reality make the depression worse. Am I right? I would appreciate your input.

Thank you.

DR. HELLER'S ANSWER:

Marijuana is very relaxing and the individual becomes totally focused on thoughts and sensations. There are problems, however, in addition to it being illegal. It has been shown to cause brain damage long term. Lung damage similar to heavy cigarette smoking can result. Many people drive under the influence and bad things can happen. Many gain considerable weight. Some become psychologically addicted. It's a sensation that can only be reproduced by using the drug, so it's not a "natural" experience that's part of being human.

Those with the BPD can go psychotic while using marijuana, which is scary - particularly if violence or self-destruction can result. Some individuals with panic and other disorders can get significantly worse on marijuana.

I don't believe in denying depression treatment because the patient is using these substances. There's a chance that once the depression is over the individual will quit using the drug.

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